Intussusception clinical pathway: a survey of pediatric surgery practices

Therapeutic reduction of intussusception by air or contrast enema may require surgery if the bowel is irreducible or perforates. There is no standard for the involvement of a pediatric surgeon in the workup of the condition. A regional survey of clinical practices was therefore undertaken to attempt...

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Bibliographic Details
Published in:The American surgeon 2014-09, Vol.80 (9), p.846-848
Main Authors: Stokes, Sean M, Iocono, Joseph A, Brown, Samuel, Draus, Jr, John M
Format: Article
Language:English
Subjects:
Critical Pathways - statistics & numerical data
Emergency medical care
Enema - utilization
Hospital systems
Humans
Ileal Diseases - surgery
Infant
Intussusception - diagnosis
Intussusception - therapy
Patients
Pediatrics
Pediatrics - statistics & numerical data
Population Surveillance
Practice Patterns, Physicians' - statistics & numerical data
Southeastern United States - epidemiology
Surgery
Surveys and Questionnaires
Treatment Outcome
Ultrasonic imaging
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Summary:Therapeutic reduction of intussusception by air or contrast enema may require surgery if the bowel is irreducible or perforates. There is no standard for the involvement of a pediatric surgeon in the workup of the condition. A regional survey of clinical practices was therefore undertaken to attempt to establish a consensus as to when the presence of a pediatric surgeon is required. Distributed to pediatric surgeons at 32 institutions, a questionnaire asked the process of imaging and reduction of infants with intussusception and the extent of pediatric surgical involvement. Surgeons at 29 institutions responded (91%). Ultrasound was used in diagnosis in 16 (55%), 13 (45%) requiring a positive ultrasound diagnosis of intussusception before attempting reduction. Three-fourths (22 [76%]) required surgeon notification that enema reduction was taking place, and one-fourth (seven [24%]) required prior surgical consultation. Only three (10%) required the presence of a surgery team member. Most (21 [72%]) did not demand one, and five (18%) indicated that surgical presence was desirable but not a necessity. There is no consensus for pediatric surgical involvement before and during reduction of an intussusception.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481408000914